It is easy to say size doesn't matter, but to people like Michael a couple of inches are all that stand between them and happiness.
Michael has a micro-penis, a rare condition that affects less than one percent of men. In adults, it means a penis that is shorter than 7cm when erect.
The average erect penis for Australians is 16cm from base to tip and 90 percent of men fall between 14.5cm and 17.5cm.
Michael, 32, says that having the penis of an infant has meant he's had sex only twice in his life.
"It has prevented me from doing or experiencing a lot of things," he told ninemsn. "I haven't experienced proper relationships. I found it difficult to talk to girls."
When he did, he found it hard to hold a relationship down.
"I didn't lose my virginity until I was 24 when I had a girlfriend for three months."
He didn't try again for six years.
Despite being otherwise fit and healthy, he dealt with intense bullying throughout primary and high schools, making it difficult to form lasting friendships.
Like many men with the condition, Michael has low self-esteem and experiences deep depression.
He says he would trade his brainpower to make the problem go away.
"I'd happily be less intelligent, lose a few IQ points and have a bigger penis," he says.
"I am now diagnosed bipolar and have pretty bad bouts of depression. My sex drive has diminished due to the anti-depressants."
Many men stress about penis size
While Michael's condition is extreme, thousands of men are so worried about their penises that they seek medical help, partly because they over-estimate the average size.
Sydney reconstructive surgeon Dr Peter Laniewski sees a large number of men seeking penis enlargement, but says for many it is not necessary.
"You get a lot of young men who watch a bit of porn and don't realise the men are chosen for their particular strengths," Dr Laniewski says.
"We have to say, 'Look, you're actually in the normal range.' But it's important to note that penis size does not correlate with fertility."
READ MORE: Penis size, what's normal?
What can you do?
For people like Michael who decide to undergo surgery, there are three main ways that surgeons can lengthen the penis.
The first involves cutting a ligament in the shaft. The surgery is followed by months of "scar stretching" which involves pulling the penis back between the legs.
"The surgery involves releasing the suspensory ligament which attaches the base of the penis to the pubic bone, but this procedure won't change the size of an erect penis, only the flaccid size," Dr Laniewski says.
"There are other procedures available that involve inserting a prosthesis into the penis or injecting a filler product, but as with any procedure you run the risk of infection."
This can be accompanied by a thickening procedure which requires a fat transplant under the penis skin.
Michael tried both the lengthening and thickening last year and found the results painful and disappointing.
"My penis is basically infant sized. Pre-surgery, I was 2-3cm flaccid and I'm now 4cm. My erection is probably around 7cm."
He is now considering visiting a specialist in the US for further surgery, but Dr Laniewski says it is difficult to lengthen the penis further after the ligament has been detached.
Learning to accept what you have
While the condition can cause several physical problems, including difficulty urinating and having sex, the major impact is often psychological.
Counselling and sport psychologist Dr Geoffrey Paul says that without other significant rites of passage to manhood, there can be undue emphasis on boys' physical development.
"It is the self-perception issue — am I man enough?" he told ninemsn.
"But unfortunately we don't have good rites of passage nowadays where we can measure ourselves against things like hunting or learning skills. Penis size can become such a huge badge of progress which is unfair because there is such a variation in the onset of puberty."
He says working to build up self-confidence and self-worth will help overcome many of the problems attributed to penis size.
"The guidance is to have self-belief and understand it isn't the only measure of being an adequate man.
"Find a partner who has a broad consideration of what a partner should be."
He says surgery should be a last resort.
"People have these surgeries for cosmetic reasons because they don't believe they fit into the normal or adequate range and that it will make them happy — but you want to exhaust all other options first."
If you are suffering from depression or mental illness, contact SANE Australia.
Do you have a rare disorder? Email us here.
Author: Philippa Lees
Approving editor: Rory Kinsella.